Partial Adrenalectomy in Patients with Primary Aldosteronism

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atients with primary aldosteronism due to unilateral and solitary adrenocortical aldosterone-producing adenoma (APA) underwent unilateral adrenalectomy or enucleation of adenoma (partial adrenalectomy). Five years after respective operations, the possibility of tumor recurrence from remnant adrenal tissues, hypothalamic-pituitary-adrenal axis function, and urinary concentrating ability were investigated to determine which method is preferable.Hypertension, hypokalemia and impaired urinary concentrating ability were improved to the same extent in the two groups. Mineralo-and glucocorticoid functions were well preserved in partially adrenalectomized patients. Remarkably low level of aldosterone production, but not cortisol production was noted in APA-adjacent tissues. Abnormal mineralocorticoid receptor-binding sites were normalized by each operation.These findings support the notion that partial adrenalectomy appears to be preferable in patients with primary aldosteronism. The likelihood of tumor recurrence from remnant ipsilateral adrenal gland appears to be lower in this operation method.

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